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Atrial flutter

Atrial flutter causes an abnormal heartbeat, but is a separate condition to the more common heart rhythm condition, atrial fibrillation.

Atrial flutter happens when an abnormal conduction circuit develops inside the atrium or upper chamber of the heart, allowing the atria to beat very fast, about 250-300 beats per minute.

Although the heart may beat faster, blood may not be pumped properly around the body.

Atrial flutter symptoms can come and go, with fast heart beat episodes lasting from some hours or days.

In some cases, atrial flutter happens all the time.

With proper treatment, atrial flutter is rarely life threatening. Complications of atrial flutter can be serious, but they can usually be prevented with treatment.

Atrial flutter causes

Atrial flutter may be caused by abnormalities or diseases of the heart itself, by a disease elsewhere in the body that affects the heart, or by consuming substances that change the way electrical impulses are transmitted through the heart. In a few people, no underlying cause is ever found

Heart diseases or abnormalities that can cause atrial flutter include the following:

  • Decreased blood flow to the heart (ischaemia) due to coronary heart disease, atherosclerosis, or a blood clot
  • High blood pressure or hypertension
  • Disease of the heart muscle ( cardiomyopathy)
  • Abnormalities of the heart valves (especially the mitral valve)
  • An abnormally enlarged chamber of the heart (hypertrophy)
  • Open heart surgery

Diseases elsewhere in the body that affect the heart include:

  • Overactive thyroid gland (hyperthyroidism)
  • Blood clot in a blood vessel in the lungs ( pulmonary embolism)
  • Chronic (ongoing, long-term) lung diseases (COPD), such as emphysema, that reduce the amount of oxygen in the blood

Substances that may contribute to atrial flutter include the following:

  • Alcohol (wine, beer, or spirits)
  • Stimulants such as cocaine, amphetamines, diet pills, cold medicines, even caffeine

Atrial flutter is closely related to another arrhythmia called atrial fibrillation. The two sometimes alternate back and forth.

Atrial flutter symptoms

Some people have no symptoms at all with atrial flutter.

Others describe the following symptoms:

  • Palpitations (rapid heartbeat or a pounding sensation in the chest)
  • A "fluttering" or tremor-like feeling in the chest
  • Shortness of breath
  • Anxiety

People with underlying heart or lung disease who experience atrial flutter may have these and other, more significant symptoms.

  • Angina pectoris (chest or heart pains)
  • Feeling faint or light-headed
  • Fainting (syncope)

When to seek medical care

If you experience any of the symptoms of atrial flutter, seek medical advice.

If you are taking medication for atrial flutter, and you experience any of the signs and symptoms described, seek medical advice straight away.

If you have been diagnosed and are being treated for atrial flutter, go immediately to A&E if you experience any of the following symptoms:

  • Severe chest pain
  • Feeling faint or light-headed
  • Actual fainting
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